Nutrition-First Support for GLP-1 and Dual Incretin Therapy in Obesity: A Practical Framework for Dietary Management, Symptom Tolerability, and Long-Term Weight Maintenance

Zambrano-Villacres, Raynier; Campuzano-Donoso, Martín; Reytor González, Claudia; Rossetti, Gianluca; Cobellis, Luigi; Cobellis, Francesco; Pilone, Vincenzo; Simancas Racines, Daniel; Schiavo, Luigi

doi:10.3390/nu18111751

Nutrition-First Support for GLP-1 and Dual Incretin Therapy in Obesity: A Practical Framework for Dietary Management, Symptom Tolerability, and Long-Term Weight Maintenance

Journal

Nutrients

ISSN

20726643

Date Issued

2026-05-29

Author(s)

Zambrano-Villacres, Raynier

Campuzano-Donoso, Martín

Reytor González, Claudia

CENTRO DE INVESTIGACIÓN DE EVIDENCIA, IMPLEMENTACIÓN Y TOMA DE DECISIONES EN SALUD

Rossetti, Gianluca

Cobellis, Luigi

Cobellis, Francesco

Pilone, Vincenzo

Simancas Racines, Daniel

CENTRO DE INVESTIGACIÓN DE EVIDENCIA, IMPLEMENTACIÓN Y TOMA DE DECISIONES EN SALUD

Schiavo, Luigi

Type

Article

DOI

10.3390/nu18111751

URL

https://cris.indoamerica.edu.ec/handle/123456789/10165

Abstract

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists have transformed obesity treatment, producing substantial weight loss during active therapy. However, real-world effectiveness may be limited by gastrointestinal adverse events, reduced dietary intake, fat-free mass loss as part of total weight reduction, and weight regain after discontinuation. Methods: This narrative review synthesizes current pharmacological, nutritional, gastrointestinal, body-composition, and implementation evidence to propose an evidence-informed nutrition-first framework for patients receiving incretin-based therapy for obesity. Results: We translate pharmacologic mechanisms into practical dietary strategies, including protein prioritization, structured meal patterns, hydration and fiber management, symptom-targeted interventions, resistance-training support, and maintenance planning. Because direct trials of structured nutrition interventions in GLP-1RA- or dual incretin-treated populations remain limited, several recommendations are extrapolated from the broader obesity, caloric restriction, body-composition, gastrointestinal, and expert-consensus literature. Conclusions: Integrating structured nutrition care into pharmacotherapy pathways may help address meal-related symptom burden, support protein and fluid adequacy, identify patients at higher nutritional or body-composition risk, and prepare patients for long-term weight-management behaviors. Embedding practical nutrition management within multidisciplinary obesity care may help translate pharmacologic efficacy into durable, patient-centered outcomes. © 2026 by the authors.